Prevalence of pulmonary mycoses in smear-negative patients with suspected tuberculosis in the Brazilian Amazon

BackgroundPulmonary mycoses resemble clinically and radiologically chronic pulmonary tuberculosis. Studies describing the prevalence, etiology and clinical features of pulmonary mycosis are of crucial importance in the Brazilian Amazon.AimsTo estimate the frequency of pulmonary mycoses in smear-negative tuberculosis patients; to describe their demographic, epidemiological, and clinical characteristics; and to evaluate diagnostic methods.MethodsA cross-sectional study was conducted at two tuberculosis reference institutions in Amazonas, Brazil. We included 213 patients and collected clinical data, blood and induced sputum to perform serological, direct microscopy, microbiologic culture and PCR-based assays to identify infections caused by Aspergillus fumigatus, Paracoccidioides brasiliensis, Histoplasma capsulatum, Cryptococcus, and HIV. Chest computed tomography was also performed.ResultsPulmonary mycoses were diagnosed in 7% (15/213) of the cases, comprising ten aspergillosis cases, three cases of paracoccidioidomycosis and one case each of histoplasmosis and cryptococcosis. Among the patients with pulmonary mycoses, 86.7% were former tuberculosis patients. The most significant clinical characteristics associated with pulmonary mycoses were cavity-shaped lung injuries, prolonged chronic cough and hemoptysis.ConclusionsOur study confirmed the high prevalence of pulmonary mycoses in smear-negative tuberculosis patients in the Brazilian Amazon.     

Prevención primaria del ictus en el anciano: evidencias actuales en el tratamiento de la hipertensión arterial

After age, arterial hypertension (AHT) is the most significant risk factor associated with stroke, and accounts for more than 25% of all strokes. The prevalence of AHT in the elderly in Spain is approximately 70%, which means that there are more than 5 million people over 65 years-old with hypertension in our country. There are currently numerous trials and meta-analyses that demonstrate that antihypertensive treatment clearly reduces the risk of stroke in elderly, and very elderly (≥80 years) subjects. However there are many areas of uncertainty such as, for example, when to start antihypertensive treatment, to what level should the blood pressure be lowered, or what is the best antihypertensive in the prevention of stroke in this population. In this article we present a review of the current evidence in the prevention of stroke in the elderly patient by means of treatment of the AHT.     

多变量置信区间法和模型依赖法在溶出曲线 相似性比较中的应用

根据 FDA 和 CFDA 口服固体制剂溶出度试验技术指导原则的要求,为防止仿制药一致性评价过程中相似因子(f2)法的滥用和 不恰当应用,采用样本数据实例演示的方式说明多变量置信区间法和模型依赖法作为补充手段在溶出曲线相似性比较和 BE 风险预评估中 的重要性。     

Modulación antioxidante y antiinflamatoria del ejercicio físico durante el envejecimiento

Aging is characterised by a gradual loss of the functional reserve. This, along with the fostering of sedentary habits and the increase in risk factors, causes a deterioration of antioxidant defences and an increase of the circulatory levels of inflammatory and oxidative markers, boosting a low-rate chronic inflammation, defined as inflamm-aging. This phenomenon is present in the aetiopathology of chronic diseases, as well as in cognitive deterioration cases associated with aging. The objective of this review is to describe the modulation of antioxidant and anti-inflammatory effects of physical exercise of moderate intensity and volume in the elderly. Evidence of its effectiveness as a non-pharmacological resource is presented, which decreases some deleterious effects of aging. This is mainly due to its neuroprotective action, the increase in circulating anti-inflammatory markers, and the improvement of antioxidant defence derived from its practice.     

Autocuidado: nueva evidencia sobre su medida en adultos mayores

Introduction

A major challenge in today's society is getting older people, not only live longer, but to have a better life, and achieve successful aging. Self-care has been identified as relevant construct in its relation to physical, psychological, and social health. Therefore, this paper aims to provide first evidence of the psychometric properties of a scale to assess self-care in older people.

Predictores de mala salud autopercibida en una población de personas mayores

Introduction

Self-Rated Health is part of the comprehensive concept of Quality of Life and is a valid measurement of health status. The main objective of this study was to test the predictive value of some different variables on the poor Self-Rated Health among elders.

Material and methods

We performed a cross-sectional study on a sample consisting of 140 participants. Measurements: age, gender, level of education, environment, cognitive status, physical impairment, diseases, health perception and social support. The influence of the studied variables on the poor Self-Rated Health was performed with a logistic regression analysis and a ROC curve to establish the cut-off values for these variables with the best sensitivity and specificity to predict the poor Self-Rated Health.

Results

A poor Self-Rated Health was significantly associated with age, comorbidity, and the perception of poor functional social support, whereas no association was found with gender, environment and educational level.

Conclusions

Old age, the number of diagnosed diseases, and functional social support are Self-Rated Health risk factors, while the characteristics and repercussions of the diseases should not be considered.     

土壤几丁质酶对土传性真菌病害的防治作用

针对生物防治在无公害农业生产中的重要性,对土壤几丁质酶的来源,几丁质酶对其真菌性病害的防治,土壤几丁质酶对土传性真菌病害的防治等的理论与应用前景进行了论述,认为可以通过人工调控的方法发挥土壤几丁质酶的生物防治作用。     

环境因素对缢蛏受精卵孵化率影响的研究

本文主要探讨了几种环境因素(温度、盐度、pH值、密度、化肥施用量及藻类)对缢蛏受精卵孵化率的影响。研究结果表明:受精卵孵化最佳条件为:温度20—25℃;pH值为7.0—8.5;适盐范围随亲蛏来源不同而异,来自低盐区的,最适盐度8—12‰,而来自高盐区的,15—30‰,温度可影响其适盐范围,25℃左右,其范围最广;受精卵的密度以50粒/毫升以下为宜;保持低浓度的藻类对其孵化有利;施用2ppm以下的硫酸铵和尿素,可促进藻类繁殖,对受精卵孵化的影响不大。     

Taking a look on fungi in cystic fibrosis: More questions than answers

Cystic fibrosis (CF) is one of the most frequent recessive inherited diseases in western countries. Advances in medical care have led to a substantial increase in the life expectancy of CF patients. Survival beyond adolescence has permitted to see fungi not only as late colonizers, but also as potential pathogens responsible of allergic reactions and chronic infections related to lung function deterioration. The role of fungi, nevertheless, has been overlooked until recently. As a result, a number of questions on their epidemiology, clinical significance, or diagnosis, among others, remain unanswered. Besides more in depth studies about the extent of the deleterious effect of fungi on the CF host, new technologies may provide the key to understand its pathogenic role, its interaction with other microbial components of the respiratory microbiota, and should pave the way to define subsets of patients at risk who would benefit from specific therapy. This review is intended to provide a quick overview on what we know about the presence of fungi in the CF airway and its repercussion in the host, and to point out some of the many knowledge gaps needed to understand and advance in the management of fungi in the airway of CF subjects.